Canadian Journal of Neurological Sciences最新文献

{"title":"Headache due to Spontaneous Intracranial Hypotension in a Patient with Vertebral Bone Metastasis.","authors":"Jihad Al Kharbooshi, Kai Xiong, Ruba Kiwan, Michael Mayich","doi":"10.1017/cjn.2025.10380","DOIUrl":"10.1017/cjn.2025.10380","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Province of Alberta Jurisdictional Standardized Operating Protocol (SOP) for Screening Brain Vascular Malformations.","authors":"Ryan Alexander Spychka, Michael D Hill, Jeremy Rempel, Sandeep Naik, Richard Owen, Oliver Halliwell, Thomas Jeerakathil, Karim Samji, Dilini Vethanayagam","doi":"10.1017/cjn.2025.10379","DOIUrl":"10.1017/cjn.2025.10379","url":null,"abstract":"<p><strong>Objective: </strong>Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant genetic disorder leading to vascular malformations in different organ systems. Approximately 10% of patients with HHT have brain vascular malformations (BVMs). Due to the negative health consequences related to BVMs, screening with MRI is recommended. There are no health jurisdictional standards for medical imaging protocols in North America or elsewhere. The objective of this project is to adopt a provincial standardized operating protocol (SOP) to improve diagnostic accuracy and reduce inappropriate imaging in patients with and without HHT in Alberta.</p><p><strong>Methods: </strong>Multiple fora were held among the five Alberta Health Services zones with stakeholders from urban, suburban and rural radiology groups, neurology, pulmonology and hematology. The consensus process took five years to complete between 2015 and 2020. The content of the fora was approved by all participants.</p><p><strong>Results: </strong>The SOP was implemented in February 2020 and defines that screening for BVMs must include standard unenhanced brain MRI (sagittal T1, axial fluid-attenuated inversion recovery and axial T2) with susceptibility-weighted imaging (SWI), a 3T or 1.5T magnet strength and minimum imaging standards to include 3 mm contiguous slice thickness.</p><p><strong>Discussion: </strong>Incorporation of SWI allowed for the elimination of MR contrast to improve access to the local performance of studies within the province, facilitating virtual care.</p><p><strong>Conclusion: </strong>A provincial SOP for BVM screening in patients with suspected or confirmed HHT was successfully implemented in Alberta. Gadolinium was avoided, as it was felt to be unnecessary for screening purposes and might complicate imaging at more remote sites.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Ndongo Sonfack et al. \"Minimally Invasive Surgery for Cervical Meningioma: Systematic Review and Case Series\".","authors":"Brij Karmur, Michael M H Yang","doi":"10.1017/cjn.2025.10368","DOIUrl":"https://doi.org/10.1017/cjn.2025.10368","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Jindal et al. \"Complications of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Systematic Literature Review\".","authors":"Kislay Kishore","doi":"10.1017/cjn.2025.10370","DOIUrl":"https://doi.org/10.1017/cjn.2025.10370","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Hypothalamic Hamartoma Causing Refractory Epilepsy: A Systematic Review.","authors":"Nausherwan Hussain, Muhammad Usman Khalid, Aliya Szpindel, Anne Bouthillier, M Zubair Tahir, Farhan A Mirza","doi":"10.1017/cjn.2025.10385","DOIUrl":"10.1017/cjn.2025.10385","url":null,"abstract":"<p><strong>Background: </strong>Hypothalamic hamartomas (HHs) are a known cause of refractory focal epilepsy. Advancement in microsurgical techniques and introduction of stereotactic ablative methods have led to improved complication rates, but the effect on seizure control is still to be determined. In this systematic review, we present a thorough analysis of published literature on the outcomes of various surgical treatments of HHs for refractory epilepsy.</p><p><strong>Methods: </strong>A literature search using the MedLine, SCOPUS and Cochrane databases was conducted. All English language studies describing surgical treatment of HH with refractory epilepsy, with a minimum of three patients and a follow-up of at least one year, were identified.</p><p><strong>Results: </strong>An initial selection of 55 studies was reduced to 41 after combining studies from the same groups; 14 open, 4 endoscopic, 8 Gamma Knife radiosurgery (GKRS), 9 laser interstitial thermal therapy (LITT) and 6 radiofrequency thermocoagulation (RF-TC) studies were included. From a total of 832 patients, 209 underwent open (25.1%), 80 endoscopic (9.6%), 124 GKRS (14.9%), 229 LITT (27.5%) and 190 RF-TC (22.8%). Engel I or ILAE 1 or 2 was achieved in: open 115 (55.0%), endoscopic 38 (47.5%), GKRS 49 (39.5%), LITT 176 (76.9%) and RF-TC 128 (67.4%). Invasive surgeries (open and endoscopic) had a higher incidence of neurological complications (27.0%) than ablative surgeries (GKRS, LITT, RF-TC) (7.2%). Reoperation rates were higher for ablative surgeries (23.8%) than invasive surgeries (9.0%).</p><p><strong>Conclusion: </strong>Surgical treatment of HH causing refractory epilepsy is effective. RF-TC and LITT surgery types have the highest Engel class I outcomes, and ablative surgeries have a lower neurological complication profile compared to open and endoscopic approaches.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Acute Stroke System of Treatment Across Canada: Findings from a National Stroke Centre Survey.","authors":"Betty Adewusi, Andrew M Demchuk, Grant Stotts, Renee Cashin, Marsha Eustace, Trish Helm-Neima, Heather Williams, Bridget Stack, Shahram Abootalebi, Julie Savoie, Alissa Decker, Melissa Buckler, Sherry Xueying Hu, Alexandre Yves Poppe, Marie-Christine Camden, Shelley Sharp, Aris Katsanos, Ravinder-Jeet Singh, Regan Spencer, Esseddeeg Ghrooda, Nishita Singh, Ruth Whelan, Regan Cooley, Mary-Lou Halabi, Balraj Mann, Brian H Buck, Sacha Arsenault, Aleksander Tkach, Hannah Shoichet, Katherine Breen, Samantha Atwan, Noreen Kamal","doi":"10.1017/cjn.2025.10386","DOIUrl":"10.1017/cjn.2025.10386","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a devastating disease, but the disability due to stroke can be avoided or reduced through timely access to treatment and care. This study surveyed all designated stroke centres across Canada to better understand the national acute stroke treatment landscape.</p><p><strong>Methods: </strong>An online survey designed to obtain information on each stroke hospital's designation level, most responsible physician for acute reperfusion treatment decision-making, availability of stroke coordinators, stroke research activity and level of transition to tenecteplase for intravenous thrombolysis was distributed to stroke centres in Canada via a network of stroke administrators and physician leads from each province. The survey responses were collated and audited for completeness and accuracy, and final responses were analysed using descriptive statistics and graphical distributions as appropriate.</p><p><strong>Results: </strong>There are a total of 205 designated stroke centres in Canada; 13.2% (<i>n</i> = 27) are endovascular thrombectomy (EVT) capable (<i>n</i> = 26 provide 24/7 access), while the rest provide thrombolysis alone, comprising primary stroke centres (<i>n</i> = 70, 34.1%) and thrombolysis-ready centres (<i>n</i> = 108, 52.7%). The presence of neurologists in the thrombolysis-capable centres is minimal, although compensated for by a high use of telestroke in making thrombolysis decisions. Participation rate in stroke clinical trials was heavily restricted to the EVT-capable centres. There were variabilities among provinces in the availability of stroke coordinators.</p><p><strong>Conclusion: </strong>The acute ischaemic stroke landscape in Canada is variable between provinces, presenting unique opportunities for collaboration. There is a need for greater availability of stroke neurologists and stroke coordinators and for diversifying site participation in clinical trials.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Ndongo Sonfack et al. \"Minimally Invasive Surgery for Cervical Meningioma: Systematic Review and Case Series\".","authors":"Daipayan Guha","doi":"10.1017/cjn.2025.10367","DOIUrl":"https://doi.org/10.1017/cjn.2025.10367","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Mahale et al. \"Adult-onset PLA2G6-Associated Neurodegeneration (PLAN): A clinical, imaging and genetic profile review\".","authors":"Marie Catherine Boll, Nancy Monroy-Jaramillo","doi":"10.1017/cjn.2025.10353","DOIUrl":"https://doi.org/10.1017/cjn.2025.10353","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reviewer Comment on Elfil et al. \"Efficacy and Safety of Hyperbaric Oxygen Therapy for Retinal Artery Occlusion: A Systematic Review and Meta-Analysis\".","authors":"Matthew Boyko, Roslynn Carberry","doi":"10.1017/cjn.2025.10365","DOIUrl":"https://doi.org/10.1017/cjn.2025.10365","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Hyperbaric Oxygen Therapy for Retinal Artery Occlusion: A Systematic Review and Meta-Analysis.","authors":"Mohamed Elfil, Hanin Sabet, Abdallah Abbas, Ahmed Bayoumi, Hazem S Ghaith, Mohamed Hesham Ghoneem, Amr Shaarawy, Monsef Ibrahim Kharboush, Mohammad Aladawi, Zaid Najdawi, Chaitanya Medicherla, Daniel A Schwartz, Kelly A Hutcheson, Daniel Elefant, Gurmeen Kaur, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1017/cjn.2025.10364","DOIUrl":"10.1017/cjn.2025.10364","url":null,"abstract":"<p><strong>Background: </strong>Retinal artery occlusion (RAO) is a vision-threatening condition with limited therapeutic options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential treatment to enhance retinal oxygenation and salvage ischemic tissue, though its efficacy and safety remain debated.</p><p><strong>Methods: </strong>We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Databases were searched through November 2024 for studies comparing HBOT with control in RAO patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses evaluated visual acuity (VA), best-corrected visual acuity (BCVA) and adverse events (AEs).</p><p><strong>Results: </strong>Nine studies with 499 patients (286 HBOT, 213 non-HBOT) met the inclusion criteria. HBOT was associated with improved BCVA (MD: -0.63, 95% CI: [-1.14, -0.12], <i>p</i> = 0.01) after sensitivity analysis. No significant differences were observed in uncorrected VA or lines of improvement. AEs included seizures (1.47%), ear barotrauma (1.65%) and epistaxis (0.83%) in the HBOT group. Notably, HBOT was associated with lower rates of neovascular glaucoma (7.89% vs. 15.79%) and stroke (4.3% vs. 16.6%) compared to controls.</p><p><strong>Conclusions: </strong>HBOT demonstrates potential for improved visual outcomes in RAO patients, particularly BCVA, with a generally favorable safety profile. However, heterogeneity among studies and limited sample sizes highlight the need for robust prospective trials to clarify its role in RAO management.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}